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Updated: Jun 12, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Published on: March 26, 2018

Arterial access for thoracic endograft placement.

Jeffrey Jim¹, Brian G Rubin, Marc R Moon

¹Division of Vascular Surgery, Department of Surgery, Washington University School of Medicine, St Louis, MO 63110, USA.

Annals of Vascular Surgery

|June 29, 2010

Summary

Choosing the right arterial access for thoracic endograft placement is crucial. Antegrade access via the ascending aorta offers a safe alternative, especially for complex cases, reducing complications.

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Area of Science:

Vascular Surgery
Interventional Cardiology
Medical Device Technology

Background:

Thoracic endograft repair has advanced since 2005.
Vascular access adequacy is a key challenge.
Access complications exceed 20% in clinical trials.

Purpose of the Study:

Evaluate arterial access methods for thoracic endograft placement.
Assess the safety and efficacy of ascending aorta access.
Analyze access-related complications.

Main Methods:

Retrospective review of 79 thoracic endograft procedures (May 2005-April 2009).
Analysis of indications, access types, technical success, and complications.
Comparison of retrograde (femoral/aortoiliac) versus antegrade (ascending aorta) access.

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Last Updated: Jun 12, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Published on: March 26, 2018

Main Results:

Overall technical success was 100%.
Overall access-related complication rate was 6%.
Antegrade ascending aorta access (11% of cases) had zero complications, unlike femoral access (76% of cases).

Conclusions:

Appropriate access selection is vital for minimizing complications.
Antegrade ascending aorta access is a safe and effective option.
Consider antegrade access for patients with challenging aortoiliac anatomy or complex procedures.